| NPI | 1508362765 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IN 71009072A)  | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH 022593)  | 
| Enumeration Date | 2018-04-04 | 
| Last Update Date | 2019-07-11 |