| NPI | 1053894121 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3014731) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH APRN.CNP.023423) |
| Enumeration Date | 2018-09-13 |
| Last Update Date | 2021-01-21 |