| NPI | 1922820661 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704421208) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024191686) |
| Enumeration Date | 2024-10-24 |
| Last Update Date | 2024-11-15 |