| NPI | 1255016416 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704324927) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MI 4704324927) |
| 363LF0000X Nurse Practitioner, Family (Licence: MI 4704324927) | |
| Enumeration Date | 2023-06-15 |
| Last Update Date | 2023-07-27 |