| NPI | 1174973168 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11001366) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN 12241) |
| 363LF0000X Nurse Practitioner, Family (Licence: OH APRN.CNP.19245) | |
| Enumeration Date | 2016-06-21 |
| Last Update Date | 2025-08-07 |