| NPI | 1104242205 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH COA.15685-NP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH 15685NP) |
| Enumeration Date | 2014-03-13 |
| Last Update Date | 2024-05-20 |