| NPI | 1316641723 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704319379) |
| Additional Taxonomies | 2080N0001X Pediatrics Neonatal-Perinatal Medicine (Licence: MI 4704319379) |
| Enumeration Date | 2023-03-29 |
| Last Update Date | 2023-06-12 |