| NPI | 1912436320 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704287063) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI 4704287063) |
| 363L00000X Nurse Practitioner (Licence: MI 4704287063) | |
| Enumeration Date | 2017-06-08 |
| Last Update Date | 2024-05-08 |