| NPI | 1811771520 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704351845) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MS 907897) |
| 363L00000X Nurse Practitioner (Licence: MI 2023058118) | |
| Enumeration Date | 2023-08-23 |
| Last Update Date | 2025-10-27 |