| NPI | 1477898807 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704300864) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: OH COA.14302-NP) |
| Enumeration Date | 2012-12-12 |
| Last Update Date | 2020-03-02 |