| NPI | 1942653753 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704329507) |
| Additional Taxonomies | 247200000X Technician, Other |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-07-16 |
| Last Update Date | 2023-09-25 |