| NPI | 1730211194 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704196438) |
| Additional Taxonomies | 363LC1500X Nurse Practitioner, Community Health (Licence: MI 4704196438) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: MI 4704196438) | |
| Enumeration Date | 2007-03-12 |
| Last Update Date | 2019-05-13 |