| NPI | 1235332164 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704200942) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4704200942) |
| Enumeration Date | 2007-06-07 |
| Last Update Date | 2014-01-24 |