NPI | 1053730390 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: OH 15849) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH COA 15849-NP) |
163WG0000X Registered Nurse, General Practice (Licence: OH RN.240900) | |
Enumeration Date | 2014-04-15 |
Last Update Date | 2024-09-17 |