| NPI | 1558598938 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704159435) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MI 4704159435) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: MI 4704159435) | |
| Enumeration Date | 2009-06-12 |
| Last Update Date | 2020-09-08 |