| NPI | 1174959373 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH 22177) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CT 5544) |
| Enumeration Date | 2013-09-19 |
| Last Update Date | 2018-05-16 |