| NPI | 1700995719 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704134425) |
| Additional Taxonomies | 163WR0006X Registered Nurse Registered Nurse First Assistant (Licence: MI 4704134425) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2016-08-22 |