| NPI | 1053662262 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704246129) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704246129) |
| Enumeration Date | 2012-09-27 |
| Last Update Date | 2015-08-20 |