| NPI | 1194703280 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71002380A) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704231878) |
| Enumeration Date | 2006-01-09 |
| Last Update Date | 2012-05-07 |