| NPI | 1760407969 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: MI 4704233285) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: OH NP 05378) |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2023-03-07 |