| NPI | 1295711380 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 119831) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: MI 119831) |
| Enumeration Date | 2005-12-20 |
| Last Update Date | 2008-07-29 |