| NPI | 1497361638 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95030150) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704293321) |
| Enumeration Date | 2020-09-22 |
| Last Update Date | 2025-01-27 |