| NPI | 1134503899 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH COA 17588- NPC) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH 334444) |
| 208VP0000X (Licence: OH COA 17588 NP) | |
| Enumeration Date | 2015-07-13 |
| Last Update Date | 2015-08-17 |