| NPI | 1518779180 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MI AG06240030) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704260577) |
| Enumeration Date | 2025-01-22 |
| Last Update Date | 2025-01-22 |