| NPI | 1225030497 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MI 4704157442) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704157442) |
| 363LC1500X Nurse Practitioner, Community Health (Licence: MI 4704157442) | |
| Enumeration Date | 2005-06-01 |
| Last Update Date | 2015-12-31 |