| NPI | 1245213511 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704122796) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WI 1028 033) |
| Enumeration Date | 2005-11-21 |
| Last Update Date | 2013-07-02 |