| NPI | 1417206285 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704270697) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH coa13805np) |
| Enumeration Date | 2012-09-07 |
| Last Update Date | 2021-11-15 |