| NPI | 1063601599 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704210538) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH rn308980) |
| 363LF0000X Nurse Practitioner, Family (Licence: MI 4704210538) | |
| Enumeration Date | 2007-10-22 |
| Last Update Date | 2023-11-03 |