| NPI | 1558766683 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 11124-33) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH COA.16642-NP) |
| 363LF0000X Nurse Practitioner, Family (Licence: OH COA16642-NP) | |
| Enumeration Date | 2014-10-31 |
| Last Update Date | 2023-01-19 |