| NPI | 1861469330 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704119195) |
| Additional Taxonomies | 174400000X Specialist (Licence: MI 4704119195) |
| Enumeration Date | 2006-03-03 |
| Last Update Date | 2009-12-23 |