| NPI | 1245668557 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3010256) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH COA.15192NP) |
| Enumeration Date | 2013-10-23 |
| Last Update Date | 2021-06-02 |