| NPI | 1285642793 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH COA.05309) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA TP005645B) |
| 363L00000X Nurse Practitioner (Licence: OH RN197805) | |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2016-06-20 |