| NPI | 1558461582 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH COA.16872-NP) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704252748) |
| 363LF0000X Nurse Practitioner, Family (Licence: MI 4704252748) | |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2023-11-03 |