| NPI | 1821674540 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704328478) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI F12200115) |
| 363LF0000X Nurse Practitioner, Family (Licence: MI F12200115) | |
| 363LF0000X Nurse Practitioner, Family (Licence: MI 4704328478) | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: MI F12200115) | |
| Enumeration Date | 2021-03-23 |
| Last Update Date | 2021-08-13 |