| NPI | 1962038513 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704294444) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MI 4704294444) |
| Enumeration Date | 2020-03-16 |
| Last Update Date | 2025-04-09 |