| NPI | 1710651641 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: MI 4704340280) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704340280) |
| Enumeration Date | 2021-08-04 |
| Last Update Date | 2025-07-17 |