| NPI | 1194311662 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704266289NSA200N7) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH APRN.CNP.0028077) |
| Enumeration Date | 2020-12-17 |
| Last Update Date | 2022-09-21 |