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 |