| NPI | 1376542126 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IN 71010493A) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH 01474) |
| Enumeration Date | 2005-07-14 |
| Last Update Date | 2020-11-17 |