| NPI | 1669365466 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: MI 4704366316) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 104756825) |
| Enumeration Date | 2025-05-30 |
| Last Update Date | 2025-05-30 |