| NPI | 1265781512 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: OH APRN.CNP.13792) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: WI AP61273754) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: VT 101.0135726) | |
| 363LF0000X Nurse Practitioner, Family (Licence: OH COA.13792-NP) | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: WA AP61273754) | |
| Enumeration Date | 2012-09-02 |
| Last Update Date | 2022-10-18 |