| NPI | 1073982591 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3009382) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH 021993) |
| Enumeration Date | 2015-09-15 |
| Last Update Date | 2020-03-12 |