| NPI | 1356694780 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH COA.14004-NP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH COA 14004) |
| Enumeration Date | 2012-10-23 |
| Last Update Date | 2014-05-09 |