| NPI | 1255105490 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704354196) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704354196) |
| Enumeration Date | 2023-11-08 |
| Last Update Date | 2025-09-27 |