NPI | 1023686441 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MI 4704330314) |
Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: MI 4704330314) |
Enumeration Date | 2021-06-13 |
Last Update Date | 2022-08-15 |