| NPI | 1982377420 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704367459) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704367459) |
| Enumeration Date | 2021-07-30 |
| Last Update Date | 2026-08-10 |