| NPI | 1447628714 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0000X (Licence: OH COA.1779-NP) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: OH COA.17779-NP) |
| Enumeration Date | 2015-09-03 |
| Last Update Date | 2021-06-02 |