| NPI | 1164900049 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH APRN.CNP.023594) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0001142337) |
| Enumeration Date | 2018-08-01 |
| Last Update Date | 2021-01-14 |