NPI | 1194708826 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: OH APRN.CNP.02176) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: OH NP-02176) |
Enumeration Date | 2005-11-28 |
Last Update Date | 2018-03-29 |