| NPI | 1649715194 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704363040) |
| Additional Taxonomies | 247200000X Technician, Other (Licence: MI W230493585298) |
| 163WP0200X Registered Nurse, Pediatrics (Licence: MI 4704363040) | |
| Enumeration Date | 2016-12-19 |
| Last Update Date | 2023-07-13 |