| NPI | 1508264615 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: OH COA.16509-NP) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner Gerontology (Licence: OH COA.16509-NP) |
| Enumeration Date | 2014-12-05 |
| Last Update Date | 2016-06-09 |