| NPI | 1104127059 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11001134) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH RN352753) |
| Enumeration Date | 2010-11-09 |
| Last Update Date | 2020-08-22 |