| NPI | 1730526849 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MI 4704201573mod17848) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704201573) |
| Enumeration Date | 2013-05-30 |
| Last Update Date | 2017-12-06 |