| NPI | 1649504952 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704298918) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2002002275) |
| Enumeration Date | 2009-09-21 |
| Last Update Date | 2014-05-09 |