| NPI | 1861948101 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704197533) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 736126) |
| Enumeration Date | 2016-08-28 |
| Last Update Date | 2023-06-12 |