| NPI | 1912634296 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704324614) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: MI 4704324614) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: MI 4704324614) | |
| Enumeration Date | 2022-08-05 |
| Last Update Date | 2022-12-07 |