| NPI | 1891479028 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MI 4704342586) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN 237629-5) |
| 363L00000X Nurse Practitioner (Licence: MN 10546) | |
| Enumeration Date | 2023-06-08 |
| Last Update Date | 2025-06-09 |