| NPI | 1013480854 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH LE-00026839) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH RN.332552) |
| Enumeration Date | 2019-01-04 |
| Last Update Date | 2019-01-04 |