| NPI | 1265671507 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704118082) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704118082) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: MI 4704118082) | |
| Enumeration Date | 2009-02-10 |
| Last Update Date | 2020-07-13 |