| NPI | 1104259647 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH COA.15035-NP) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: OH COA 15035 NP) |
| Enumeration Date | 2013-08-20 |
| Last Update Date | 2023-08-03 |