| 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 |