| NPI | 1255512935 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024168191) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH COA.09787.NP) |
| Enumeration Date | 2007-11-21 |
| Last Update Date | 2013-07-08 |