| NPI | 1053318212 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MI 4704277297) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: SC APN27) |
| Enumeration Date | 2005-07-02 |
| Last Update Date | 2023-03-07 |