| NPI | 1386940864 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5006198) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 260352) |
| 363LF0000X Nurse Practitioner, Family (Licence: OH COA.12241) | |
| Enumeration Date | 2011-02-01 |
| Last Update Date | 2022-01-06 |