| NPI | 1154890085 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11011969) |
| Additional Taxonomies | 163WE0003X Registered Nurse, Emergency (Licence: OH 199127) |
| 363LF0000X Nurse Practitioner, Family (Licence: MI 4704184898NSA2103P) | |
| Enumeration Date | 2018-11-20 |
| Last Update Date | 2021-07-14 |