| NPI | 1164896411 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH 18289) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 95003264) |
| Enumeration Date | 2015-11-24 |
| Last Update Date | 2020-01-22 |