| NPI | 1124623624 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH aprn.cnp.0027719) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH APRN.CNP.0027719) |
| Enumeration Date | 2020-12-02 |
| Last Update Date | 2021-01-28 |