| NPI | 1720135627 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704105570) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704105570) |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2016-03-23 |