| NPI | 1417279365 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 36300000X) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4704159872) |
| Enumeration Date | 2010-02-19 |
| Last Update Date | 2017-07-25 |