| NPI | 1649524588 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MI 4704163632) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704163632) |
| Enumeration Date | 2012-10-30 |
| Last Update Date | 2021-03-24 |