| NPI | 1609503788 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704434753) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA SP000) |
| Enumeration Date | 2022-08-08 |
| Last Update Date | 2026-03-13 |