| NPI | 1275953747 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: MI 4704132309) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MI 4704132309) |
| Enumeration Date | 2014-04-23 |
| Last Update Date | 2015-08-31 |