| NPI | 1306171624 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH COA11034-NP)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3006208)  | 
| Enumeration Date | 2009-10-05 | 
| Last Update Date | 2019-07-24 |