| NPI | 1124865936 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MI 4704403369) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 824472) |
| 163W00000X Registered Nurse (Licence: MI 4704403369) | |
| Enumeration Date | 2024-07-09 |
| Last Update Date | 2026-09-03 |