NPI | 1114678257 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH 0037595) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 2021117108) |
363LF0000X Nurse Practitioner, Family (Licence: FL 11017532) | |
Enumeration Date | 2022-01-11 |
Last Update Date | 2024-11-30 |