| NPI | 1952048613 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704183105) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: MI 4704183105) |
| Enumeration Date | 2022-05-15 |
| Last Update Date | 2023-06-05 |