| NPI | 1962922732 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704291536) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704291536) |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: MI 4704291536) | |
| Enumeration Date | 2017-06-22 |
| Last Update Date | 2018-03-17 |