| NPI | 1780489195 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA 242698) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704421800) |
| 163W00000X Registered Nurse (Licence: MO 2018034083) | |
| Enumeration Date | 2025-02-18 |
| Last Update Date | 2025-08-20 |