NPI | 1659815207 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MI 4704239260) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704239260) |
Enumeration Date | 2016-12-15 |
Last Update Date | 2025-06-24 |