| NPI | 1588446355 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704319949) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5022163) |
| Enumeration Date | 2023-10-17 |
| Last Update Date | 2025-09-16 |