| NPI | 1013049352 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: MI 4704110586) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704110586) |
| Enumeration Date | 2007-03-12 |
| Last Update Date | 2012-02-01 |