| NPI | 1043367311 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: MI 4704075871) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704075871) | 
| Enumeration Date | 2007-01-05 | 
| Last Update Date | 2025-09-11 |