| NPI | 1033155486 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MI 4704180693) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: GA 119695) |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2013-03-27 |