| NPI | 1285377135 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704305430) | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704305430) | 
| Enumeration Date | 2022-04-19 | 
| Last Update Date | 2025-10-06 |