| NPI | 1316598931 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH APRN.CNP.026446) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024178245) | 
| Enumeration Date | 2019-09-25 | 
| Last Update Date | 2020-06-11 |