| NPI | 1265304620 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MI 4704398106) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704398106) |
| Enumeration Date | 2025-09-23 |
| Last Update Date | 2025-12-09 |