| NPI | 1982315735 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704319161) |
| Additional Taxonomies | 363LP0222X Nurse Practitioner, Pediatrics, Critical Care (Licence: MI 4704319161) |
| Enumeration Date | 2022-12-12 |
| Last Update Date | 2023-01-23 |