| NPI | 1316493711 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704271380) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH APRN.CNP.019999) |
| Enumeration Date | 2016-08-26 |
| Last Update Date | 2022-10-18 |