| NPI | 1053848614 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704295819) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704295819) |
| Enumeration Date | 2017-05-15 |
| Last Update Date | 2024-10-24 |