| NPI | 1477296010 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH 0030692) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 0030692) |
| 363LF0000X Nurse Practitioner Family (Licence: OH 0030692) | |
| Enumeration Date | 2022-04-20 |
| Last Update Date | 2024-06-07 |