| NPI | 1043469588 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704252212) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704252212) |
| Enumeration Date | 2008-09-09 |
| Last Update Date | 2010-03-29 |