| NPI | 1841373651 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704230419) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R175881-4) |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2015-10-08 |