| NPI | 1144232471 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704132060) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704132060) |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2021-01-19 |