| NPI | 1245593110 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: MI 4704248817) |
| Additional Taxonomies | 363LW0102X Nurse Practitioner Women's Health (Licence: MI 4704248817) |
| Enumeration Date | 2012-06-16 |
| Last Update Date | 2021-01-27 |