| NPI | 1902205818 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704285017) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.011658) |
| Enumeration Date | 2014-08-15 |
| Last Update Date | 2023-03-07 |