| NPI | 1679773444 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: AZ AP4227) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MI 4704236232) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: CA 17071) | |
| Enumeration Date | 2007-07-20 |
| Last Update Date | 2011-12-15 |