| NPI | 1821179946 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704113883) |
| Additional Taxonomies | 367A00000X Advanced Practice Midwife (Licence: MI 4704113883) |
| 363LF0000X Nurse Practitioner, Family (Licence: MI 4704113883) | |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2020-02-28 |