| NPI | 1891495420 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704333466)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 4043844)  | 
| 363LF0000X Nurse Practitioner, Family (Licence: SC 29264)  | |
| Enumeration Date | 2023-03-02 | 
| Last Update Date | 2025-09-17 |