| NPI | 1396712832 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704110346) |
| Additional Taxonomies | 174400000X Specialist (Licence: MI 4704110346) |
| Enumeration Date | 2006-03-03 |
| Last Update Date | 2015-02-02 |