| NPI | 1932752136 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11002220) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704366368) |
| Enumeration Date | 2019-07-17 |
| Last Update Date | 2021-02-02 |