| NPI | 1790460897 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704316008) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704316008) |
| Enumeration Date | 2023-06-16 |
| Last Update Date | 2023-10-02 |