NPI | 1063602464 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH APRN.CNP.0028030) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH RN.334939-) |
363LF0000X Nurse Practitioner, Family (Licence: GA RN274597) | |
Enumeration Date | 2007-07-31 |
Last Update Date | 2024-10-12 |