| NPI | 1922736131 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MI 4704348994) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4704348994) |
| Enumeration Date | 2022-08-15 |
| Last Update Date | 2025-10-28 |