| NPI | 1225290067 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH COA.12353NP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 669291) |
| Enumeration Date | 2008-07-01 |
| Last Update Date | 2012-04-09 |