| NPI | 1093701252 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: OH COA.11882-NP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: NC 154576) |
| 363LF0000X Nurse Practitioner Family (Licence: KY 3006830) | |
| Enumeration Date | 2005-09-23 |
| Last Update Date | 2012-03-02 |