| NPI | 1538507769 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH 14554) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH COA14554NP) |
| Enumeration Date | 2013-06-10 |
| Last Update Date | 2020-06-15 |