| NPI | 1801874268 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704180870) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN 71002015A) |
| Enumeration Date | 2006-01-05 |
| Last Update Date | 2013-01-04 |