| NPI | 1164704169 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH COA.12563-NP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH RX.12563-EX1) |
| Enumeration Date | 2011-09-15 |
| Last Update Date | 2012-04-19 |