| NPI | 1104259647 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 28979) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: SC 28979) |
| 363L00000X Nurse Practitioner (Licence: OH COA.15035-NP) | |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: OH COA 15035 NP) | |
| Enumeration Date | 2013-08-20 |
| Last Update Date | 2025-10-28 |