| NPI | 1508085531 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704185213) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704185213) |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2016-07-29 |