| NPI | 1184262479 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AZ 271470) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH RN.434434) |
| 363L00000X Nurse Practitioner (Licence: OH 026129) | |
| Enumeration Date | 2019-12-17 |
| Last Update Date | 2022-07-28 |