| NPI | 1811327943 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704262598) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN 28181907A) |
| Enumeration Date | 2013-11-27 |
| Last Update Date | 2019-03-07 |