| NPI | 1194395947 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MI 4704330053) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704330053) |
| Enumeration Date | 2021-06-24 |
| Last Update Date | 2023-03-23 |