| NPI | 1104975747 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5006705) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5006705) |
| 363L00000X Nurse Practitioner (Licence: OH NP-07477) | |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2026-07-19 |