| NPI | 1144801390 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: OH 0029231) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704227421) |
| 363L00000X Nurse Practitioner (Licence: OH 0029231) | |
| Enumeration Date | 2021-04-19 |
| Last Update Date | 2022-02-05 |