| NPI | 1023457140 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704243108) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MI 4704243108) |
| Enumeration Date | 2013-06-21 |
| Last Update Date | 2017-01-25 |