| NPI | 1740077007 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704331103) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704331103) |
| Enumeration Date | 2025-04-21 |
| Last Update Date | 2026-03-30 |