| NPI | 1063060028 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MI 4704284760) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704284760) |
| Enumeration Date | 2019-09-03 |
| Last Update Date | 2025-07-23 |