| NPI | 1508997040 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704164214) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704164214) |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2010-09-02 |