| NPI | 1013403872 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0222X Nurse Practitioner, Pediatrics, Critical Care (Licence: MN 6013) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704324282) |
| 163W00000X Registered Nurse (Licence: UT 9045484-3102) | |
| 163WP0200X Registered Nurse, Pediatrics (Licence: MN 195264-9) | |
| Enumeration Date | 2018-07-05 |
| Last Update Date | 2018-07-23 |