| NPI | 1700204377 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH 020723) |
| Additional Taxonomies | 282N00000X General Acute Care Hospital (Licence: MI 4704260758) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: MI 4704260758) | |
| Enumeration Date | 2014-04-01 |
| Last Update Date | 2019-08-06 |