| NPI | 1164768560 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH COA 14295-NP) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH RN.326335) |
| Enumeration Date | 2012-12-13 |
| Last Update Date | 2016-01-19 |