| NPI | 1912365206 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704366243) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OK 119495) |
| Enumeration Date | 2016-02-02 |
| Last Update Date | 2021-02-15 |