| NPI | 1992241103 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704291062) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704291062) |
| Enumeration Date | 2017-01-11 |
| Last Update Date | 2024-01-04 |