| NPI | 1053967653 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3013651) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH APRN.CNP.024869) |
| Enumeration Date | 2019-08-11 |
| Last Update Date | 2020-09-24 |