| NPI | 1528878212 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704388869NSA250H1) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704388869) |
| Enumeration Date | 2025-01-13 |
| Last Update Date | 2025-06-24 |