| NPI | 1790056471 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: MI 4704266076) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704266076) |
| Enumeration Date | 2012-01-26 |
| Last Update Date | 2015-06-18 |