| NPI | 1033672480 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704298513) | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704298513) | 
| 363LA2100X Nurse Practitioner, Acute Care (Licence: MI 4704298513) | |
| Enumeration Date | 2019-04-12 | 
| Last Update Date | 2020-03-16 |