| 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 |