| NPI | 1861875445 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MI 4704243688) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: FL ARNP9301335) |
| 363L00000X Nurse Practitioner (Licence: FL ARNP9301335) | |
| Enumeration Date | 2015-07-01 |
| Last Update Date | 2018-03-17 |