| NPI | 1265095152 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 9466659) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL 9466659) |
| 163W00000X Registered Nurse (Licence: OH 314130) | |
| Enumeration Date | 2019-04-17 |
| Last Update Date | 2019-10-08 |