| NPI | 1851616551 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704169919) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704216919) |
| Enumeration Date | 2010-04-06 |
| Last Update Date | 2014-01-02 |