| NPI | 1689266793 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH APRN.CNP.0030045) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704322696) |
| Enumeration Date | 2021-02-09 |
| Last Update Date | 2022-01-26 |