| NPI | 1245479765 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704244308) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MI 4704244308) |
| Enumeration Date | 2009-02-05 |
| Last Update Date | 2019-09-03 |