| NPI | 1225594518 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704304621) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704304621) |
| Enumeration Date | 2019-02-12 |
| Last Update Date | 2026-01-19 |