| NPI | 1730523598 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: MI 4704265711) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: MI 6801065539) |
| 163WC1500X Registered Nurse Community Health (Licence: MI 4704265711) | |
| Enumeration Date | 2013-04-24 |
| Last Update Date | 2014-01-29 |