| NPI | 1528615929 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN 30613) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH LE-00028518) |
| Enumeration Date | 2019-08-20 |
| Last Update Date | 2021-12-21 |