| NPI | 1851642748 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704253578) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 772574) |
| Enumeration Date | 2012-10-02 |
| Last Update Date | 2016-02-04 |