| NPI | 1548593353 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704244655) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: MI 4704244655) |
| Enumeration Date | 2009-09-10 |
| Last Update Date | 2022-08-17 |