| NPI | 1336802792 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 26006) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH 368245) |
| 163W00000X Registered Nurse (Licence: TN 237231) | |
| 363LF0000X Nurse Practitioner, Family (Licence: OH COA.17240-NP) | |
| Enumeration Date | 2021-10-21 |
| Last Update Date | 2021-10-21 |