NPI | 1316330798 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704247273) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704247273) |
363LP0200X Nurse Practitioner, Pediatrics (Licence: MI 4704247273) | |
Enumeration Date | 2015-03-10 |
Last Update Date | 2022-10-25 |