| NPI | 1013100593 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH COA 13327 NP) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R-161420-4) |
| Enumeration Date | 2007-08-20 |
| Last Update Date | 2019-02-15 |