| NPI | 1093173924 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: OH 18712) |
| Additional Taxonomies | 261QP2300X Clinic/Center Primary Care (Licence: OH COA.18712-NP) |
| Enumeration Date | 2016-02-06 |
| Last Update Date | 2020-12-22 |