| NPI | 1972362697 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704325425) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4704325425) |
| Enumeration Date | 2024-03-15 |
| Last Update Date | 2024-03-28 |