| NPI | 1992084222 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704246600) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704246600) |
| 163W00000X Registered Nurse (Licence: IN 28177932A) | |
| Enumeration Date | 2011-08-04 |
| Last Update Date | 2018-12-19 |