| NPI | 1134502040 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2100X Nurse Practitioner Acute Care (Licence: MI 4704234529) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704234529) |
| Enumeration Date | 2015-07-09 |
| Last Update Date | 2015-07-24 |