| NPI | 1528681681 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704275715) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0024190929) |
| 363LF0000X Nurse Practitioner, Family (Licence: MI 4704275715) | |
| 163W00000X Registered Nurse (Licence: MI 4704275715) | |
| 363L00000X Nurse Practitioner (Licence: OH APRN.CNP.0037219) | |
| Enumeration Date | 2020-05-24 |
| Last Update Date | 2025-07-30 |