| NPI | 1114217718 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: OH RN.390789) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NC 242243) |
| Enumeration Date | 2011-04-15 |
| Last Update Date | 2013-04-23 |