| NPI | 1811590623 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: IN 71011297A) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: MI 4704270659) |
| Enumeration Date | 2020-11-16 |
| Last Update Date | 2021-07-22 |