| NPI | 1407182926 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: OH COA10896) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH COA.10896) |
| 363L00000X Nurse Practitioner (Licence: CA 95001616) | |
| Enumeration Date | 2009-10-19 |
| Last Update Date | 2019-06-20 |