| 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 |