| NPI | 1417412602 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH APRN.CNP.024619) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH RN.304080) |
| Enumeration Date | 2019-02-01 |
| Last Update Date | 2019-05-22 |