| NPI | 1649861352 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MI 4704342216) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704342216) |
| Enumeration Date | 2021-01-27 |
| Last Update Date | 2026-07-15 |