| NPI | 1114972916 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: OH APRN.CNP.19221) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704147261) |
| 363LF0000X Nurse Practitioner, Family (Licence: MI 4704147261) | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: MI 4704147261) | |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2018-06-26 |