| NPI | 1619119898 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LC1500X Nurse Practitioner, Community Health (Licence: MI 4704244027) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704244027) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: MI 4704244027) | |
| Enumeration Date | 2009-04-02 |
| Last Update Date | 2020-01-20 |