| NPI | 1114494200 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704278777) |
| Additional Taxonomies | 363LP0222X Nurse Practitioner, Pediatrics, Critical Care (Licence: CA 95010439) |
| 363LP0222X Nurse Practitioner, Pediatrics, Critical Care (Licence: MI 4704278777) | |
| Enumeration Date | 2018-10-27 |
| Last Update Date | 2020-03-06 |