| NPI | 1669767935 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: MI 4704290093) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: FL ot14109) |
| Enumeration Date | 2011-06-15 |
| Last Update Date | 2014-10-23 |