| NPI | 1891028262 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MI 4704220310) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 660568) |
| Enumeration Date | 2009-09-16 |
| Last Update Date | 2024-05-02 |