| NPI | 1578817698 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: OH COA 13698-NP) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MI 4704294979) |
| Enumeration Date | 2012-10-29 |
| Last Update Date | 2022-03-11 |