| NPI | 1639921653 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704291153) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 71015430A) |
| Enumeration Date | 2024-04-03 |
| Last Update Date | 2025-05-23 |