NPI | 1053454447 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704175148) |
Additional Taxonomies | 163WD0400X Registered Nurse, Diabetes Educator (Licence: MI 4704175148) |
Enumeration Date | 2007-02-15 |
Last Update Date | 2010-09-27 |