| NPI | 1063291730 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704353588) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704353588) |
| Enumeration Date | 2023-09-22 |
| Last Update Date | 2024-07-29 |