| NPI | 1548784085 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH 021321) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3014450) |
| Enumeration Date | 2017-07-26 |
| Last Update Date | 2021-03-05 |