| NPI | 1184384646 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704313258) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704313258) |
| 163W00000X Registered Nurse (Licence: MI 4704313258) | |
| Enumeration Date | 2021-12-26 |
| Last Update Date | 2024-11-21 |