| NPI | 1467796821 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704229540) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704229540) |
| Enumeration Date | 2012-11-23 |
| Last Update Date | 2016-10-27 |