| NPI | 1619219003 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704182052) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: MI 4704182052) |
| Enumeration Date | 2013-03-23 |
| Last Update Date | 2013-08-27 |