| NPI | 1992279517 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704292329) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO F01190058) |
| 363LF0000X Nurse Practitioner, Family (Licence: MO 2010039959) | |
| Enumeration Date | 2019-01-16 |
| Last Update Date | 2022-03-11 |