| NPI | 1194430322 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704367199NSA240LA) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704367199) |
| Enumeration Date | 2023-01-23 |
| Last Update Date | 2025-06-23 |