| NPI | 1275932246 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704252833) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: MI 4704252833) |
| Enumeration Date | 2014-08-15 |
| Last Update Date | 2021-04-22 |