| NPI | 1467604223 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704239194) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: MI 4704239194) |
| Enumeration Date | 2008-10-10 |
| Last Update Date | 2017-05-03 |