| NPI | 1174526057 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH APRN.CNP.0027524) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3003443) |
| Enumeration Date | 2005-05-24 |
| Last Update Date | 2020-12-28 |