| NPI | 1376083857 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3011201)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH APRN.CNP.020644)  | 
| Enumeration Date | 2017-03-02 | 
| Last Update Date | 2022-03-03 |