| NPI | 1578954301 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704327239) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH COA.17068-NP) |
| Enumeration Date | 2015-02-16 |
| Last Update Date | 2020-03-15 |