| NPI | 1871059436 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704399492) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3015554) |
| 363L00000X Nurse Practitioner (Licence: OH 024561) | |
| 363LF0000X Nurse Practitioner, Family (Licence: OH F02190677) | |
| 363LF0000X Nurse Practitioner, Family (Licence: KY 3015554) | |
| Enumeration Date | 2019-02-19 |
| Last Update Date | 2024-03-14 |