| NPI | 1407289432 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MI 4704247426) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704247426) |
| Enumeration Date | 2013-08-13 |
| Last Update Date | 2025-12-02 |