| NPI | 1376786095 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704235520) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 1524368) |
| Enumeration Date | 2009-04-10 |
| Last Update Date | 2014-01-03 |