| NPI | 1790128965 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704339174) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 22640) |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: NV APRN001930) | |
| Enumeration Date | 2013-04-08 |
| Last Update Date | 2019-01-14 |