| NPI | 1114949435 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: OH COA05675) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: PA TP005634W) |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2021-02-26 |