| NPI | 1154182624 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704379174) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704379174) |
| 363LF0000X Nurse Practitioner, Family (Licence: FL 4704379174) | |
| Enumeration Date | 2024-01-22 |
| Last Update Date | 2025-10-18 |