| NPI | 1700423662 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH APRN.CNP.026048) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704358517) |
| Enumeration Date | 2019-12-10 |
| Last Update Date | 2020-03-17 |