| NPI | 1053409771 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SC 18444) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI AS191691) |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2020-10-14 |