| NPI | 1558608240 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704148512) |
| Additional Taxonomies | 163WC1400X Registered Nurse, College Health (Licence: MI 4704148512) |
| Enumeration Date | 2013-01-15 |
| Last Update Date | 2022-01-10 |