| NPI | 1235494212 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 5600-33) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: OH COA13469-NP) |
| Enumeration Date | 2012-07-06 |
| Last Update Date | 2013-12-04 |