| NPI | 1962170407 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704297482) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704297482) |
| Enumeration Date | 2021-08-31 |
| Last Update Date | 2021-11-11 |