| NPI | 1396448726 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704380123) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 28165725A) |
| Enumeration Date | 2023-03-24 |
| Last Update Date | 2024-02-22 |