| NPI | 1114509254 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F348898) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH RN.468142) |
| Enumeration Date | 2021-04-27 |
| Last Update Date | 2021-12-22 |