| NPI | 1154757052 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: OH 0028839) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CT 5526) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: WA AP60696749) | |
| Enumeration Date | 2013-09-24 |
| Last Update Date | 2022-11-11 |