| NPI | 1568078343 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704339930) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI AG02200139) |
| Enumeration Date | 2020-09-17 |
| Last Update Date | 2025-10-08 |