| NPI | 1558728550 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704215111) |
| Additional Taxonomies | 376G00000X Nursing Home Administrator (Licence: MI 4704215111) |
| Enumeration Date | 2016-01-21 |
| Last Update Date | 2016-01-21 |