| NPI | 1184072134 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MI 4704274227) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704274227) |
| Enumeration Date | 2016-06-01 |
| Last Update Date | 2016-09-29 |