| NPI | 1215174149 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH 14526)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH 336348)  | 
| Enumeration Date | 2009-01-14 | 
| Last Update Date | 2020-11-19 |