| NPI | 1154160133 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704300080) |
| Additional Taxonomies | 163WH0200X Registered Nurse, Home Health (Licence: MI 4704300080) |
| 163W00000X Registered Nurse (Licence: MI 4704300080) | |
| Enumeration Date | 2024-05-21 |
| Last Update Date | 2026-04-08 |