| NPI | 1073197562 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704263051) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704263051) |
| Enumeration Date | 2021-05-10 |
| Last Update Date | 2023-01-25 |