| NPI | 1164849766 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH COA 18922-NP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 337949) |
| Enumeration Date | 2014-03-21 |
| Last Update Date | 2016-04-27 |