| NPI | 1679001192 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704290820) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704290820) |
| Enumeration Date | 2017-05-28 |
| Last Update Date | 2024-02-22 |