| NPI | 1245860402 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: MI 4704432968) |
| Additional Taxonomies | 164X00000X Licensed Vocational Nurse (Licence: TX 337163) |
| Enumeration Date | 2020-01-16 |
| Last Update Date | 2026-03-31 |