| NPI | 1164690723 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: MI 4704276621) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MI 6802082200) |
| Enumeration Date | 2008-02-18 |
| Last Update Date | 2011-02-18 |