| NPI | 1023403458 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CT 10670) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704287168) |
| 363L00000X Nurse Practitioner (Licence: MI 4704287168) | |
| Enumeration Date | 2015-04-02 |
| Last Update Date | 2022-08-05 |