| NPI | 1558036111 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704313967) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704313967) |
| Enumeration Date | 2021-08-14 |
| Last Update Date | 2022-07-20 |