| NPI | 1447660659 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: MI 4704178863) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704178863) |
| Enumeration Date | 2014-04-28 |
| Last Update Date | 2017-04-14 |