| NPI | 1104266311 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH APRN.CNP.14561) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH COA.14561-NP) |
| Enumeration Date | 2013-07-02 |
| Last Update Date | 2018-05-22 |