| NPI | 1558651117 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: FL ARNP9268617) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: OH COA12301-NP) |
| Enumeration Date | 2011-04-15 |
| Last Update Date | 2012-03-19 |