| NPI | 1821149725 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704167564) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704167564) |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2012-03-21 |