| NPI | 1861772030 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH COA.12557-NP) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH RN.296988) |
| 363L00000X Nurse Practitioner (Licence: MI 4704288993) | |
| Enumeration Date | 2011-08-19 |
| Last Update Date | 2023-11-03 |