| NPI | 1386303196 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: MI 4704321864) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: ID 72242) |
| Enumeration Date | 2021-12-09 |
| Last Update Date | 2025-07-24 |