| NPI | 1043952567 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MI 4704330661) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704330661) |
| Enumeration Date | 2022-04-13 |
| Last Update Date | 2022-07-19 |