| NPI | 1508029687 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: OH 03611-NP) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: KY 3001842) |
| Enumeration Date | 2008-07-08 |
| Last Update Date | 2014-12-22 |