| NPI | 1558622498 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: MI 4704252761) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704252761) |
| Enumeration Date | 2012-06-07 |
| Last Update Date | 2024-05-01 |