| NPI | 1265557706 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5008223) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704196933) |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2016-02-16 |