| NPI | 1174584684 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IA A176857) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704298894) |
| 363LF0000X Nurse Practitioner Family (Licence: CO 129513) | |
| 363LP0200X Nurse Practitioner Pediatrics (Licence: IA A176857) | |
| Enumeration Date | 2006-04-01 |
| Last Update Date | 2024-03-14 |