| NPI | 1255679049 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH 16911) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH 357984) |
| Enumeration Date | 2013-01-29 |
| Last Update Date | 2015-09-30 |