| NPI | 1174566681 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MA 2363556) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: OH NP-08619) |
| 363LP2300X Nurse Practitioner Primary Care (Licence: MA 2363356) | |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2022-12-05 |