| NPI | 1790221190 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704308807) |
| Additional Taxonomies | 363LN0005X Nurse Practitioner Neonatal, Critical Care (Licence: MI 4704308807) |
| Enumeration Date | 2017-01-10 |
| Last Update Date | 2020-05-13 |