| NPI | 1265915748 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: MI 4704304162) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704304162) |
| Enumeration Date | 2018-09-11 |
| Last Update Date | 2019-06-11 |