| NPI | 1790278349 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LN0000X Nurse Practitioner Neonatal (Licence: MI 4704271337) |
| Additional Taxonomies | 163WH0200X Registered Nurse Home Health (Licence: MI 4704271337) |
| Enumeration Date | 2018-06-08 |
| Last Update Date | 2025-09-29 |