| NPI | 1073401485 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704391669) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704391669NSA250H0) |
| Enumeration Date | 2025-06-25 |
| Last Update Date | 2025-08-18 |