| NPI | 1164088209 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH APRN.CNP.025129) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 144833) |
| Enumeration Date | 2019-05-14 |
| Last Update Date | 2019-07-22 |