| NPI | 1336850320 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704314536) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 2022064577) |
| Enumeration Date | 2022-12-09 |
| Last Update Date | 2022-12-09 |