| NPI | 1235250218 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH COA19062NP) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 9243545) |
| 363LF0000X Nurse Practitioner, Family (Licence: WI 3453-33) | |
| 363LF0000X Nurse Practitioner, Family (Licence: KY 0024170147) | |
| 363LF0000X Nurse Practitioner, Family (Licence: VA 0024170147) | |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2021-12-15 |