| NPI | 1376317412 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704343232) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704343232) |
| Enumeration Date | 2023-11-09 |
| Last Update Date | 2024-10-11 |