| NPI | 1629543939 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: MI 4704392950) |
| Additional Taxonomies | 164X00000X Licensed Vocational Nurse (Licence: TX 338628) |
| Enumeration Date | 2018-10-12 |
| Last Update Date | 2023-11-09 |