| NPI | 1801533864 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704327523) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704327523) |
| Enumeration Date | 2022-05-19 |
| Last Update Date | 2023-11-27 |