| NPI | 1306848312 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 470411172) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704111172) |
| Enumeration Date | 2005-08-10 |
| Last Update Date | 2011-03-04 |