| NPI | 1033790241 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704314300) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704314300) |
| Enumeration Date | 2021-04-19 |
| Last Update Date | 2021-12-09 |