| NPI | 1023867843 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SC 28594) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704245528) |
| 363L00000X Nurse Practitioner (Licence: NM 80009) | |
| Enumeration Date | 2024-05-14 |
| Last Update Date | 2025-11-04 |