| NPI | 1306242813 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: TN 29563) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MI 4724242205) |
| Enumeration Date | 2014-11-10 |
| Last Update Date | 2025-04-24 |