| NPI | 1295327203 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704355922) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4704355922) |
| Enumeration Date | 2021-02-10 |
| Last Update Date | 2024-10-16 |