| NPI | 1922646199 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704303983) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MI 4704303983) |
| Enumeration Date | 2019-12-18 |
| Last Update Date | 2022-12-22 |