| NPI | 1598470189 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704330052) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA SP032955) |
| Enumeration Date | 2023-01-18 |
| Last Update Date | 2025-06-02 |