| NPI | 1407527286 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704392939) | 
| Additional Taxonomies | 163WP2201X Registered Nurse, Ambulatory Care (Licence: WA RN60970105) | 
| Enumeration Date | 2021-09-22 | 
| Last Update Date | 2023-01-31 |