NPI | 1356619068 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: OH COA.12447-NP) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: OH RN326850-COA1) |
363LA2200X Nurse Practitioner, Adult Health (Licence: OH RX12447-EX1) | |
Enumeration Date | 2011-12-08 |
Last Update Date | 2020-10-13 |