| NPI | 1407971377 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NH 071197-23) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704187558) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: MI 4704187558) | |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2015-03-02 |