| NPI | 1225035843 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MI 4704141476) |
| Additional Taxonomies | 163WG0100X Registered Nurse, Gastroenterology (Licence: MI 4704141476) |
| Enumeration Date | 2005-06-29 |
| Last Update Date | 2012-09-27 |