| NPI | 1700088077 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704239002) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704239002) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: MI 4704239002) | |
| 363LC1500X Nurse Practitioner, Community Health (Licence: MI 4704239002) | |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2020-07-08 |