NPI | 1154608867 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH cnp.11346) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: OH 11346NP) |
Enumeration Date | 2011-11-09 |
Last Update Date | 2021-05-11 |