| NPI | 1053091223 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704404591) |
| Additional Taxonomies | 363LN0000X Nurse Practitioner, Neonatal (Licence: MI 4704404591) |
| Enumeration Date | 2023-07-21 |
| Last Update Date | 2023-11-02 |