| NPI | 1104103613 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN11011984) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH 12857-NP) |
| Enumeration Date | 2011-11-11 |
| Last Update Date | 2026-03-25 |