| NPI | 1740524594 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704272577) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA RN680698) |
| 363LF0000X Nurse Practitioner, Family (Licence: PA SP016058) | |
| 363LF0000X Nurse Practitioner, Family (Licence: OH RN.355324) | |
| 363LF0000X Nurse Practitioner, Family (Licence: OH APRN.CNP.14347) | |
| Enumeration Date | 2012-11-18 |
| Last Update Date | 2021-11-01 |