| NPI | 1114119617 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704307959) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH NP 09499) |
| Enumeration Date | 2007-08-17 |
| Last Update Date | 2022-09-17 |