| NPI | 1083016547 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN310130) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH 0033034) |
| 363LF0000X Nurse Practitioner, Family (Licence: MI 4704244811) | |
| Enumeration Date | 2014-09-16 |
| Last Update Date | 2024-03-08 |