| NPI | 1972959351 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704351677) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 95004308) |
| Enumeration Date | 2016-05-04 |
| Last Update Date | 2023-08-08 |