| NPI | 1487056974 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3008943) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH 16513) |
| Enumeration Date | 2014-09-16 |
| Last Update Date | 2021-03-15 |