| NPI | 1043367311 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: MI 4704075871) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704075871) |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2007-07-08 |