| NPI | 1902233265 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704238772) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4704238772) |
| Enumeration Date | 2013-10-02 |
| Last Update Date | 2018-12-11 |