| NPI | 1639660046 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704231587) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704231587) |
| Enumeration Date | 2018-05-21 |
| Last Update Date | 2021-08-23 |