| NPI | 1245519628 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: KY 3008619) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: OH COA12455NP) |
| Enumeration Date | 2011-08-16 |
| Last Update Date | 2021-09-24 |