| NPI | 1366897696 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704278661) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704278661) |
| Enumeration Date | 2016-04-23 |
| Last Update Date | 2023-11-08 |