| NPI | 1003498759 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704288200) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704288200) |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: MI 4704288200) | |
| Enumeration Date | 2021-04-22 |
| Last Update Date | 2022-10-07 |