| NPI | 1316758774 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: MI 4704305846) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 2025027482) |
| Enumeration Date | 2025-01-15 |
| Last Update Date | 2025-09-05 |