| NPI | 1720817992 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 47044322761) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704322761) |
| Enumeration Date | 2024-07-29 |
| Last Update Date | 2025-10-23 |