| NPI | 1174115752 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704272187) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: MI 4704272187) |
| Enumeration Date | 2021-02-05 |
| Last Update Date | 2022-10-20 |