| NPI | 1538180013 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH COA08202NP) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 4910P) |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2016-10-18 |