| NPI | 1407003718 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH NP-05919) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 461971) |
| Enumeration Date | 2008-08-19 |
| Last Update Date | 2008-08-19 |