NPI | 1295269355 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704303573) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MI 4704303573) |
Enumeration Date | 2017-04-16 |
Last Update Date | 2025-03-13 |