| NPI | 1316619901 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704302008) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 1052618) |
| Enumeration Date | 2021-10-01 |
| Last Update Date | 2025-04-29 |