NPI | 1245093343 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207QA0000X Family Medicine, Adolescent Medicine (Licence: OH AG12230049) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH AG12230049) |
Enumeration Date | 2024-02-01 |
Last Update Date | 2024-09-24 |