| NPI | 1982652152 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NV APRN001686) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704141964) |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2014-06-10 |