| NPI | 1831595040 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704236723) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CT 14280) |
| Enumeration Date | 2014-11-16 |
| Last Update Date | 2025-04-01 |