| NPI | 1306247630 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 4044151) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704367140) |
| 363L00000X Nurse Practitioner (Licence: OH APRN.CNP.18291) | |
| Enumeration Date | 2014-09-05 |
| Last Update Date | 2025-08-13 |