| NPI | 1275635955 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704260751) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 124001) |
| Enumeration Date | 2006-09-02 |
| Last Update Date | 2023-06-06 |