| NPI | 1083482178 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH 0035037) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704342762NSA230SR) |
| Enumeration Date | 2023-12-18 |
| Last Update Date | 2024-02-12 |