| NPI | 1992254320 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MA RN2311003) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MI 4704292307) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: MI 4704292307) | |
| Enumeration Date | 2016-09-27 |
| Last Update Date | 2023-04-17 |