| NPI | 1124373816 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: OH COA.13621-NP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: KY 3008409) |
| Enumeration Date | 2012-07-18 |
| Last Update Date | 2015-11-18 |