| NPI | 1699149880 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: MI 4704292740) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704292740) |
| Enumeration Date | 2015-11-25 |
| Last Update Date | 2016-12-30 |