| NPI | 1710341995 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: MI 4703103541) |
| Additional Taxonomies | 302R00000X Health Maintenance Organization |
| Enumeration Date | 2016-04-13 |
| Last Update Date | 2022-11-22 |