| NPI | 1780498113 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704364728) |
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: MI 4704364728) |
| Enumeration Date | 2025-02-05 |
| Last Update Date | 2025-02-05 |