| NPI | 1023067113 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704156681) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: MI 4704156681) |
| Enumeration Date | 2006-05-08 |
| Last Update Date | 2011-03-01 |