| NPI | 1871716902 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MI 4704287125) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: VA 0024167209) |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2020-12-16 |