| NPI | 1679839161 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: MI 4704190410) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704190410) |
| Enumeration Date | 2012-04-09 |
| Last Update Date | 2020-10-20 |