| NPI | 1689352874 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704362970) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH 1129489) |
| Enumeration Date | 2023-07-07 |
| Last Update Date | 2024-02-07 |