| NPI | 1518672799 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC REVE-RZPK0) |
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: MI 4704326949) |
| Enumeration Date | 2023-01-23 |
| Last Update Date | 2024-06-22 |