| NPI | 1689773301 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704208860) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI MI43032332) |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2021-05-15 |