| NPI | 1831112085 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704222700)  | 
| Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: MI 4704222700)  | 
| 163WW0000X Registered Nurse, Wound Care (Licence: MI 4704222700)  | |
| 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: MI 4704222700)  | |
| Enumeration Date | 2006-07-26 | 
| Last Update Date | 2025-10-23 |