| NPI | 1922774959 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MI 4704264369) |
| Additional Taxonomies | 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: MI 4704264369) |
| Enumeration Date | 2021-08-19 |
| Last Update Date | 2021-08-19 |