| NPI | 1053048306 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704394190) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH 0031777) |
| Enumeration Date | 2022-08-05 |
| Last Update Date | 2023-11-03 |