| NPI | 1619778446 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704363779) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704363779NSA25079) |
| Enumeration Date | 2025-03-19 |
| Last Update Date | 2025-06-05 |