| NPI | 1104456359 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA RN2351379) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: OH APRN.CNP.025415) |
| Enumeration Date | 2020-01-16 |
| Last Update Date | 2022-03-14 |