| NPI | 1245364744 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MI 4704186729) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NC 139517) |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2021-09-27 |