| NPI | 1790439883 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: RI APRN04946) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704362781) |
| Enumeration Date | 2022-02-08 |
| Last Update Date | 2026-05-11 |