| NPI | 1942616222 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MI 4704201826) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704201826) |
| 363LP2300X Nurse Practitioner Primary Care (Licence: MI 4704201826) | |
| Enumeration Date | 2014-07-07 |
| Last Update Date | 2021-03-11 |