| NPI | 1497464580 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: OH 0032237) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: WV 103470) |
| Enumeration Date | 2022-11-17 |
| Last Update Date | 2024-12-16 |