| NPI | 1104167360 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3009268) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3009268) |
| 363LF0000X Nurse Practitioner, Family (Licence: OH COA.09782-NP) | |
| Enumeration Date | 2013-03-12 |
| Last Update Date | 2022-11-04 |