| NPI | 1194346130 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704311262) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704311262) |
| 163WE0003X Registered Nurse, Emergency (Licence: MI 4704311262) | |
| Enumeration Date | 2020-04-30 |
| Last Update Date | 2023-03-15 |