| NPI | 1528494911 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704301959) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 28185385A) |
| Enumeration Date | 2013-09-18 |
| Last Update Date | 2013-09-18 |