| NPI | 1023623808 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH aprn.cnp.0027517) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: OH APRN.CNP.0027517) |
| Enumeration Date | 2020-09-09 |
| Last Update Date | 2020-10-22 |