| NPI | 1932439981 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704406442) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX 776327) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: MI 4704406442) | |
| Enumeration Date | 2010-01-13 |
| Last Update Date | 2023-10-19 |