| NPI | 1104450691 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH APRNCNP026383) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: OH RN312060) |
| Enumeration Date | 2020-02-24 |
| Last Update Date | 2022-02-07 |