| NPI | 1063670677 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MI 4704232095) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: FL ARNP9237397) |
| Enumeration Date | 2008-05-30 |
| Last Update Date | 2012-04-11 |