| NPI | 1003627936 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704326171) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704326171) |
| 363L00000X Nurse Practitioner (Licence: FL APRN11043501) | |
| Enumeration Date | 2025-01-20 |
| Last Update Date | 2025-11-13 |