| NPI | 1205230356 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: OH COA. 17479-NP) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH 382482) |
| 363L00000X Nurse Practitioner (Licence: KY 3010119) | |
| Enumeration Date | 2014-10-17 |
| Last Update Date | 2017-10-16 |