| NPI | 1558342642 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: OH NP01320)  | 
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: OH RN126949)  | 
| Enumeration Date | 2005-11-07 | 
| Last Update Date | 2016-02-04 |