| NPI | 1235545112 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MI 4704257061) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704257061) |
| Enumeration Date | 2014-07-11 |
| Last Update Date | 2022-10-24 |