| NPI | 1063847150 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: OH 0035344) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 167586-30) |
| 363L00000X Nurse Practitioner (Licence: WI 5747-33) | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: WI 5747) | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA 95015794) | |
| Enumeration Date | 2013-09-07 |
| Last Update Date | 2023-12-17 |