| NPI | 1619695582 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WG0000X Registered Nurse, General Practice (Licence: MI 4704317773) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704317773) |
| Enumeration Date | 2022-08-17 |
| Last Update Date | 2022-08-17 |