| NPI | 1417619214 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AZ 290478) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH 0030094) |
| 363L00000X Nurse Practitioner (Licence: MI 4704356150) | |
| Enumeration Date | 2021-10-08 |
| Last Update Date | 2024-09-24 |