| NPI | 1124112396 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH NP-01870) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH RN-178798) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2007-07-08 |