| NPI | 1104955392 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: OH COA.08879-NP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: OH RN.163037-COA1) |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2018-05-07 |