| NPI | 1376857045 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704181919) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MI 4704181919) |
| Enumeration Date | 2010-08-04 |
| Last Update Date | 2012-09-13 |