| NPI | 1154925964 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH APRN.CNP.025436) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: OH CNP.025436) |
| Enumeration Date | 2020-11-23 |
| Last Update Date | 2021-02-04 |