| NPI | 1396043626 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704238769) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MI F0211152) |
| Enumeration Date | 2011-03-10 |
| Last Update Date | 2016-01-15 |