| NPI | 1912395575 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704266147) |
| Additional Taxonomies | 363LP0222X Nurse Practitioner, Pediatrics, Critical Care (Licence: MI 4704266147) |
| Enumeration Date | 2015-01-06 |
| Last Update Date | 2015-01-30 |