| NPI | 1902131915 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704213580) |
| Additional Taxonomies | 171W00000X Contractor |
| Enumeration Date | 2009-10-08 |
| Last Update Date | 2025-07-28 |