| NPI | 1851838809 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704277091)  | 
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MI 4704277091)  | 
| 363LG0600X Nurse Practitioner, Gerontology (Licence: MI 4704277091)  | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: MI 4704277091)  | |
| Enumeration Date | 2017-01-30 | 
| Last Update Date | 2021-03-09 |