| NPI | 1679549778 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704237033) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704237033) |
| 163WE0003X Registered Nurse, Emergency (Licence: NJ 26NN07581200) | |
| 363LF0000X Nurse Practitioner, Family (Licence: NJ 26NN07581200) | |
| 171000000X Military Health Care Provider (Licence: MI 4704237033) | |
| Enumeration Date | 2006-02-27 |
| Last Update Date | 2007-08-14 |