| NPI | 1114259256 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: OH COA02734NP) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: OH COA02734NP) |
| Enumeration Date | 2010-01-29 |
| Last Update Date | 2016-04-13 |