| NPI | 1174291512 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3016682) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH 0029447) |
| Enumeration Date | 2021-09-01 |
| Last Update Date | 2021-10-05 |