| NPI | 1548666092 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH COA.16798-NP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH RN.360746-COA1) |
| Enumeration Date | 2014-11-11 |
| Last Update Date | 2015-12-30 |