| NPI | 1780639302 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704207734) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4704207734) |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2015-09-29 |