| NPI | 1225430929 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704148154)  | 
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: MI 4704148154)  | 
| Enumeration Date | 2014-09-24 | 
| Last Update Date | 2016-08-03 |