| NPI | 1548366065 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704221099) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704221099) |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2022-07-21 |