| NPI | 1205023926 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ND R33229) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH 298435) |
| Enumeration Date | 2007-09-26 |
| Last Update Date | 2011-03-29 |