| NPI | 1790248250 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704226222) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704226222) |
| 163WN0800X Registered Nurse, Neuroscience (Licence: MI 00330383) | |
| Enumeration Date | 2019-04-11 |
| Last Update Date | 2020-03-23 |