| NPI | 1649534736 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MI 4704155765) |
| Additional Taxonomies | 364SA2200X Clinical Nurse Specialist, Adult Health (Licence: MI 4704155765) |
| Enumeration Date | 2012-07-03 |
| Last Update Date | 2012-07-03 |