| NPI | 1104107044 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: OH COA #12609-NP) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH RN# 296650) |
| Enumeration Date | 2011-09-06 |
| Last Update Date | 2011-09-06 |