| NPI | 1053046805 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: OH 0031779) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH APRN.CNP.0031779) |
| Enumeration Date | 2022-07-17 |
| Last Update Date | 2024-03-29 |