| NPI | 1114574779 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH APRN.CNP.025612) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH 371196) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: OH 201914503) | |
| Enumeration Date | 2019-08-19 |
| Last Update Date | 2019-10-04 |