| NPI | 1871270967 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11027102) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704405228) |
| 363L00000X Nurse Practitioner (Licence: FL 11027102) | |
| Enumeration Date | 2023-06-29 |
| Last Update Date | 2023-11-10 |