| NPI | 1376881607 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: OH APRN.CNP.14103) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: PA SP015019) |
| Enumeration Date | 2013-01-22 |
| Last Update Date | 2022-01-25 |