| NPI | 1992742753 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704215622) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI JE215622) |
| 363L00000X Nurse Practitioner (Licence: MI 4704215622) | |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2021-11-08 |