| NPI | 1174997738 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5015991) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH COA.18208) |
| Enumeration Date | 2015-11-19 |
| Last Update Date | 2023-03-24 |