| NPI | 1306079785 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH COA.10894-NP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 337548) |
| Enumeration Date | 2009-09-01 |
| Last Update Date | 2020-04-21 |