| NPI | 1790288058 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704172273) |
| Additional Taxonomies | 163WL0100X Registered Nurse, Lactation Consultant (Licence: MI 4704172273) |
| Enumeration Date | 2018-03-13 |
| Last Update Date | 2019-12-19 |