| NPI | 1194336644 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH APRN.CNP.0030669) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 1007964) |
| Enumeration Date | 2020-08-10 |
| Last Update Date | 2022-12-06 |