| NPI | 1518580836 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704355427) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704355427) |
| Enumeration Date | 2020-05-20 |
| Last Update Date | 2024-07-18 |