| NPI | 1407167000 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9360446) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH COA11424) |
| Enumeration Date | 2010-06-29 |
| Last Update Date | 2019-06-07 |