| NPI | 1780816520 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 2005010680) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704225887) |
| 363LF0000X Nurse Practitioner, Family (Licence: MO 2021017489) | |
| Enumeration Date | 2009-08-12 |
| Last Update Date | 2024-11-18 |