| NPI | 1164977195 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: SC 20112) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: OH COA.18979-NP) |
| Enumeration Date | 2016-08-19 |
| Last Update Date | 2019-08-28 |