| NPI | 1164450474 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: OH APRN.CNP.16903) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NH 048222-23-03) |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2021-09-07 |