| NPI | 1962134825 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704342548) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704342548) |
| 363LF0000X Nurse Practitioner, Family (Licence: MI 2023126823) | |
| Enumeration Date | 2022-06-29 |
| Last Update Date | 2024-06-12 |