| NPI | 1255679171 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: OH COA.17574-NP) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH RN267314) |
| Enumeration Date | 2013-01-28 |
| Last Update Date | 2019-11-12 |