| NPI | 1013324508 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 5083185-4405) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH 15918) |
| Enumeration Date | 2014-07-16 |
| Last Update Date | 2015-06-29 |