NPI | 1962954354 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MI 4704265506) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: MI 4704265506) |
Enumeration Date | 2016-11-01 |
Last Update Date | 2025-06-19 |