| NPI | 1700946654 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704131145) |
| Additional Taxonomies | 363LC1500X Nurse Practitioner, Community Health (Licence: MI 4704131145) |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2018-01-18 |