| NPI | 1063568418 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH 14492) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704235000) |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2022-07-22 |