| NPI | 1457671679 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704253620) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704253620) |
| Enumeration Date | 2010-06-10 |
| Last Update Date | 2017-12-05 |