| NPI | 1003389081 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 470-4349870) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH APRN.CNP.023503) |
| Enumeration Date | 2019-01-02 |
| Last Update Date | 2019-10-15 |