| NPI | 1184278863 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: OH APRN.CNP.025296) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: OH APRN.CNP.025296) |
| Enumeration Date | 2019-07-30 |
| Last Update Date | 2024-10-11 |