| NPI | 1366564478 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: OH APRN.CNP.04875) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH COA.04875-NP) | 
| Enumeration Date | 2007-04-06 | 
| Last Update Date | 2017-01-19 |