| NPI | 1821419805 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: MI 4704178019) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: MI 4704178019) |
| Enumeration Date | 2013-12-18 |
| Last Update Date | 2013-12-18 |