| NPI | 1356548770 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704220536) |
| Additional Taxonomies | 163WR0006X Registered Nurse, Registered Nurse First Assistant (Licence: MI 4704220536) |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2015-10-01 |