| NPI | 1215765102 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: MI 4704187312) |
| Additional Taxonomies | 172V00000X Community Health Worker (Licence: MI 2024402) |
| Enumeration Date | 2024-07-23 |
| Last Update Date | 2024-08-05 |