| NPI | 1235449521 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704163050) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MI 4704163050) |
| Enumeration Date | 2010-10-20 |
| Last Update Date | 2011-01-07 |