| NPI | 1104295211 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MT 104395) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH COA-17332) |
| 363LF0000X Nurse Practitioner Family (Licence: OH COA-17332) | |
| Enumeration Date | 2015-09-18 |
| Last Update Date | 2023-11-27 |