| NPI | 1417383613 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704272120) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 197500) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: OH APRN.CNP.0035386) | |
| Enumeration Date | 2013-09-19 |
| Last Update Date | 2024-01-09 |