| NPI | 1104547108 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MI 4704351209) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: HI APRN-3762) |
| Enumeration Date | 2022-09-07 |
| Last Update Date | 2026-02-26 |