| NPI | 1528302221 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH COA 14029-NP) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH COA.14029-NP) |
| 163W00000X Registered Nurse (Licence: MI 4704283041) | |
| Enumeration Date | 2012-11-19 |
| Last Update Date | 2020-02-24 |