| NPI | 1033547658 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11018944) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704253397) | 
| 363L00000X Nurse Practitioner (Licence: MI 4704253397) | |
| Enumeration Date | 2013-10-16 | 
| Last Update Date | 2025-07-17 |