| NPI | 1972157436 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MI 4704285749) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704285749) |
| Enumeration Date | 2019-08-01 |
| Last Update Date | 2019-09-25 |