| NPI | 1114306032 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MO 2018016873) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 2018016873) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: OH NP-17101) | |
| 363LF0000X Nurse Practitioner, Family (Licence: OH NP-17101) | |
| Enumeration Date | 2015-05-26 |
| Last Update Date | 2019-03-05 |