| NPI | 1275840209 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704178487) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH COA11707NP) |
| Enumeration Date | 2010-09-13 |
| Last Update Date | 2020-10-07 |