| NPI | 1609022243 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704250149) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN 28155366A) |
| Enumeration Date | 2008-08-14 |
| Last Update Date | 2016-10-20 |