| NPI | 1417074824 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH COA14354NP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: GA RN 169061 NP) |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2016-06-14 |