| NPI | 1205826336 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: IN 71001608A) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: OH COA.07779-NP) |
| Enumeration Date | 2005-10-28 |
| Last Update Date | 2021-09-16 |