| NPI | 1275830762 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704357616) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: PA SP011175) |
| Enumeration Date | 2011-02-17 |
| Last Update Date | 2024-03-26 |