| NPI | 1225395270 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: OH 177574-COA1) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH COA13197NP) |
| Enumeration Date | 2012-04-16 |
| Last Update Date | 2013-09-17 |