| NPI | 1578232369 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MI 4704377143) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MI 21237030501) |
| Enumeration Date | 2021-09-07 |
| Last Update Date | 2022-06-30 |