| NPI | 1104108331 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH APRN.CNP.022645) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH RN - 254785) |
| 163W00000X Registered Nurse (Licence: KY 1127279) | |
| Enumeration Date | 2011-09-14 |
| Last Update Date | 2018-05-08 |