| NPI | 1043686967 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4351049097) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 6561-33) |
| 363L00000X Nurse Practitioner (Licence: WI 173937-30) | |
| Enumeration Date | 2015-08-14 |
| Last Update Date | 2022-05-09 |