| NPI | 1528367687 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704315332) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2260475) |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: MA RN2260475) | |
| Enumeration Date | 2011-03-15 |
| Last Update Date | 2021-02-22 |