| NPI | 1750579967 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: SC 18184) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MI 4704231115) |
| Enumeration Date | 2007-10-12 |
| Last Update Date | 2013-07-15 |