| NPI | 1053867390 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: OH APRN.CNP.19204) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH COA.19204-NP) |
| Enumeration Date | 2016-08-28 |
| Last Update Date | 2018-06-11 |