| NPI | 1336122399 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704172544) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 95024219) |
| Enumeration Date | 2005-11-23 |
| Last Update Date | 2023-08-24 |