| NPI | 1154258150 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704373670) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NM 90719) |
| Enumeration Date | 2026-05-05 |
| Last Update Date | 2026-07-24 |