| NPI | 1912239476 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 6106) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704243791) |
| Enumeration Date | 2010-02-09 |
| Last Update Date | 2015-08-31 |