| NPI | 1780960633 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MI 4704245443) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704245443) |
| Enumeration Date | 2011-10-24 |
| Last Update Date | 2025-06-10 |