| NPI | 1053764530 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: OH APRN.CNP.019473) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: OH .019473) |
| Enumeration Date | 2016-07-19 |
| Last Update Date | 2019-03-13 |