| NPI | 1003364696 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704282994) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: ID 7471353) |
| Enumeration Date | 2016-09-13 |
| Last Update Date | 2025-07-22 |