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 |