| NPI | 1184090771 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704286461) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 31286) |
| Enumeration Date | 2015-08-18 |
| Last Update Date | 2025-11-26 |