| NPI | 1821577479 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704369106) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN262199) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: MI 4704369106) | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: GA RN262199) | |
| Enumeration Date | 2018-08-13 |
| Last Update Date | 2023-07-11 |