NPI | 1417379611 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: OH cao-15307-np) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH APRN.CNP.15307) |
363LP2300X Nurse Practitioner, Primary Care (Licence: IL 209.025729) | |
363LP2300X Nurse Practitioner, Primary Care (Licence: MI 4704357985) | |
363LP2300X Nurse Practitioner, Primary Care (Licence: IN 71012906A) | |
Enumeration Date | 2014-01-08 |
Last Update Date | 2025-10-08 |