| NPI | 1487263364 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TN 28003) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MI 4704418131) |
| 163W00000X Registered Nurse (Licence: NC 246751) | |
| Enumeration Date | 2020-07-28 |
| Last Update Date | 2026-01-02 |