| NPI | 1417379611 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: OH cao-15307-np) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: MI 4704357985) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: IL 209.025729) | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: IN 71012906A) | |
| Enumeration Date | 2014-01-08 |
| Last Update Date | 2022-09-13 |