| NPI | 1467740878 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704305788) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH COA.12443-NP) |
| Enumeration Date | 2011-07-19 |
| Last Update Date | 2021-06-10 |