| NPI | 1245962299 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MI 4704354404) |
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: MI 4704354404) |
| Enumeration Date | 2022-06-28 |
| Last Update Date | 2026-06-03 |