| NPI | 1366542433 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH COA.05725-NP) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4714236251) |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2009-01-19 |