| NPI | 1558615419 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LC1500X Nurse Practitioner, Community Health (Licence: MI 4704218703) |
| Additional Taxonomies | 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: MI 4704218703) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: MI 4704218703) | |
| Enumeration Date | 2012-10-31 |
| Last Update Date | 2016-07-14 |