| NPI | 1871598755 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH APRN.CNP.15770) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: IN 71001587A) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: MI 4704166593) | |
| Enumeration Date | 2005-06-16 |
| Last Update Date | 2019-05-24 |