| NPI | 1457162125 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704292224) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704292224) |
| Enumeration Date | 2025-01-14 |
| Last Update Date | 2025-08-17 |