| NPI | 1164652350 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH CNP-020179) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: OH APRN.CNP.020179) |
| Enumeration Date | 2009-07-22 |
| Last Update Date | 2020-08-07 |