| NPI | 1710684535 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 21144062348) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704293709) |
| Enumeration Date | 2023-02-13 |
| Last Update Date | 2026-01-09 |