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 |