| NPI | 1912060377 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MI 4704134368) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704134368) |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2019-10-17 |