| NPI | 1184928517 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: OR 10043801) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704244076) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: MI 4704244076) | |
| Enumeration Date | 2010-12-28 |
| Last Update Date | 2025-09-08 |