| NPI | 1528102118 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MI 4704103020) |
| Additional Taxonomies | 364SP0200X Clinical Nurse Specialist, Pediatrics (Licence: MI 4704103020) |
| Enumeration Date | 2007-02-16 |
| Last Update Date | 2016-12-30 |