| NPI | 1083131783 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704369559) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: ID 4704369559) |
| Enumeration Date | 2017-08-24 |
| Last Update Date | 2025-09-17 |