| NPI | 1104005719 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH RN145148) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: OH RN 145148) |
| Enumeration Date | 2007-10-31 |
| Last Update Date | 2019-01-18 |