| NPI | 1053644831 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH APRN.CNP.0034201) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH 287003) |
| 261QP2300X Clinic/Center, Primary Care (Licence: OH APRN.CNP.0034201) | |
| Enumeration Date | 2009-09-11 |
| Last Update Date | 2023-06-27 |