| NPI | 1316933112 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: OH COA03086) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: OH RN102601 NP03086) |
| Enumeration Date | 2005-09-27 |
| Last Update Date | 2012-10-05 |