| NPI | 1750520268 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MI 4704184295) |
| Additional Taxonomies | 163WS0121X Registered Nurse, Plastic Surgery (Licence: MI 4704184295) |
| 363L00000X Nurse Practitioner (Licence: MI 4704184295) | |
| Enumeration Date | 2009-02-09 |
| Last Update Date | 2013-02-28 |