| NPI | 1710455795 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: MI 4704397880) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704397880) |
| Enumeration Date | 2018-11-07 |
| Last Update Date | 2024-01-17 |