| NPI | 1063758142 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5006132) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: OH 20122290) |
| Enumeration Date | 2012-12-18 |
| Last Update Date | 2020-10-28 |