| NPI | 1780133033 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704235716) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704235716) |
| Enumeration Date | 2016-09-28 |
| Last Update Date | 2020-02-26 |