| NPI | 1306401690 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: MI 4704300349) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704300349) |
| Enumeration Date | 2019-05-02 |
| Last Update Date | 2019-05-02 |