| NPI | 1023553286 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LX0106X Nurse Practitioner, Occupational Health (Licence: OH APRN.CNP.020348) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH APRN.CNP.020348) |
| Enumeration Date | 2016-12-27 |
| Last Update Date | 2020-12-29 |