| NPI | 1568694776 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MI 4704199297) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CO SNP20012) |
| 363L00000X Nurse Practitioner (Licence: AZ AP3372) | |
| Enumeration Date | 2009-08-20 |
| Last Update Date | 2025-12-01 |