| NPI | 1184012064 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH 16574) |
| Additional Taxonomies | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: OH 16574) |
| Enumeration Date | 2014-12-31 |
| Last Update Date | 2022-03-31 |