| NPI | 1336186659 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: KY 3003296) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH COA.07133-NP) |
| 363L00000X Nurse Practitioner (Licence: KY 1094815) | |
| 363LF0000X Nurse Practitioner Family (Licence: OH COA07133NP) | |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2017-06-08 |