| NPI | 1275931628 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MI 4704269422) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: CT 14281) |
| Enumeration Date | 2014-12-17 |
| Last Update Date | 2026-07-15 |