| NPI | 1659742260 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704277946) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 163W00000X Registered Nurse (Licence: MI 4704277946) | |
| 163W00000X Registered Nurse (Licence: CO 182561) | |
| Enumeration Date | 2015-10-08 |
| Last Update Date | 2024-02-12 |