| NPI | 1124306212 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704205067) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH APRN.CNP.019976) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: MI 4704205067) | |
| Enumeration Date | 2011-07-25 |
| Last Update Date | 2023-01-11 |