| NPI | 1003288457 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704316352) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH 361679) |
| 163W00000X Registered Nurse (Licence: VA 0001241905) | |
| Enumeration Date | 2015-10-26 |
| Last Update Date | 2015-10-29 |