| NPI | 1063693158 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: OH 310293) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH APRN.CNP.024058) |
| Enumeration Date | 2007-11-17 |
| Last Update Date | 2019-02-14 |