| NPI | 1164410700 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: OH COA.05365-NP) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: OH COA.05365-NP) |
| Enumeration Date | 2005-10-07 |
| Last Update Date | 2022-02-14 |