| NPI | 1215112073 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA F02170659) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH APRN.CNP.0031835) |
| 261QV0200X Clinic/Center, VA (Licence: OH APRN.CNP.0031835) | |
| Enumeration Date | 2007-12-28 |
| Last Update Date | 2023-01-18 |