| NPI | 1811493984 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NM 65707) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704308948) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: MI 4704308948) | |
| Enumeration Date | 2018-04-05 |
| Last Update Date | 2022-11-29 |