| NPI | 1023485182 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704389046) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH COA-17818-NP) |
| Enumeration Date | 2015-08-25 |
| Last Update Date | 2024-11-12 |