| NPI | 1194977579 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MI 4704315610) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN 175236-0) |
| Enumeration Date | 2008-10-16 |
| Last Update Date | 2015-10-06 |