| NPI | 1528633898 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704397655) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024181262) |
| Enumeration Date | 2021-05-20 |
| Last Update Date | 2023-08-15 |