| NPI | 1396208559 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704199015) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704199015) |
| 163WM0705X Registered Nurse, Medical-Surgical (Licence: TX 1018930) | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: TX 1018930) | |
| Enumeration Date | 2019-04-12 |
| Last Update Date | 2022-09-05 |