| NPI | 1629194428 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IN 71005085A) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: OH NP07202) |
| 363L00000X Nurse Practitioner (Licence: MI 4704189142) | |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2015-04-08 |