| NPI | 1063645448 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH 022229) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 711370) |
| 363LF0000X Nurse Practitioner, Family (Licence: CA 95007840) | |
| Enumeration Date | 2009-09-01 |
| Last Update Date | 2022-12-22 |