NPI | 1407163629 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH COA.17406-NP) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH 362614) |
363L00000X Nurse Practitioner (Licence: OH APRN.CNP.17406) | |
Enumeration Date | 2010-09-09 |
Last Update Date | 2021-04-01 |