| NPI | 1487649588 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704141066) |
| Additional Taxonomies | 163WG0100X Registered Nurse, Gastroenterology (Licence: MI 4704141066) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: MI 4704141066) | |
| Enumeration Date | 2005-09-14 |
| Last Update Date | 2014-02-05 |