| NPI | 1295045995 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704128700) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI L1856091) |
| Enumeration Date | 2010-10-14 |
| Last Update Date | 2015-12-30 |