| NPI | 1376766402 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704221939) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: MI 4704221939) |
| 363LC1500X Nurse Practitioner Community Health (Licence: MI 4704221939) | |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2018-12-05 |