| NPI | 1073830428 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: MI 4704223063) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MI 4704223063) |
| 363LW0102X Nurse Practitioner Women's Health (Licence: MI 4704223063) | |
| Enumeration Date | 2010-04-26 |
| Last Update Date | 2014-04-10 |