| NPI | 1629479498 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704195393) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704222319) |
| Enumeration Date | 2014-09-11 |
| Last Update Date | 2025-05-16 |