| NPI | 1265178776 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704318925) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704318925) |
| 163W00000X Registered Nurse (Licence: MI 4704318925) | |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: MI 4704318925) | |
| Enumeration Date | 2022-05-08 |
| Last Update Date | 2024-10-23 |