| NPI | 1104460914 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH APRN.CNP.026241) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH RN.393699) |
| Enumeration Date | 2019-11-05 |
| Last Update Date | 2020-02-18 |