| NPI | 1447293477 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704219653) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 191487) |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2023-05-30 |