| NPI | 1679912695 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MI 4704257149) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704257149) |
| Enumeration Date | 2013-06-24 |
| Last Update Date | 2017-05-03 |