| NPI | 1134401193 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: MI 4704267687) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704267687) |
| Enumeration Date | 2011-09-15 |
| Last Update Date | 2015-07-28 |