NPI | 1124315247 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: OH APRN.CNP.11566) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH RN250540-COA1) |
Enumeration Date | 2011-07-10 |
Last Update Date | 2022-02-10 |