| NPI | 1194411884 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704324784) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704324784) |
| Enumeration Date | 2023-04-14 |
| Last Update Date | 2024-05-16 |