| NPI | 1922479591 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704274742) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL ARNP9379468) |
| Enumeration Date | 2015-10-08 |
| Last Update Date | 2018-08-24 |