| NPI | 1114165065 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 4002263) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH 422850) |
| 363L00000X Nurse Practitioner (Licence: OH 0032332) | |
| 363LF0000X Nurse Practitioner, Family (Licence: OH APRN.CNP.0032332) | |
| Enumeration Date | 2009-01-30 |
| Last Update Date | 2023-08-16 |