NPI | 1881713618 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704120368) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MI SHA1-0428-5824) |
Enumeration Date | 2007-03-29 |
Last Update Date | 2012-12-17 |