| NPI | 1619463619 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: MI 4704293259)  | 
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MI 4704293259)  | 
| 363LG0600X Nurse Practitioner, Gerontology (Licence: MI 4704293259)  | |
| Enumeration Date | 2018-07-03 | 
| Last Update Date | 2025-04-30 |