| NPI | 1386894160 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MI 4704217918) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704217918) |
| Enumeration Date | 2008-09-29 |
| Last Update Date | 2011-10-17 |