| NPI | 1477021160 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704169802) | 
| Additional Taxonomies | 163WD0400X Registered Nurse, Diabetes Educator (Licence: MI 4704169802) | 
| Enumeration Date | 2018-11-12 | 
| Last Update Date | 2018-12-14 |