| NPI | 1639577828 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704264825) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH 409653-COA16895) |
| Enumeration Date | 2014-12-20 |
| Last Update Date | 2018-12-11 |