| NPI | 1508518655 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: OH APRN.CNP.0029725) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH RN.441119) |
| Enumeration Date | 2022-01-20 |
| Last Update Date | 2022-01-20 |