NPI | 1104224542 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH COA.18792-NP) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH 264515) |
Enumeration Date | 2014-12-17 |
Last Update Date | 2023-02-28 |