| NPI | 1144361858 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704263745) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH NP02926) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: MI 4704263745) | |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2008-07-03 |