| NPI | 1558771352 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AZ 283134) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN 6951) |
| 363L00000X Nurse Practitioner (Licence: OH CNP.15677) | |
| 363LF0000X Nurse Practitioner, Family (Licence: OH COA 15677-NP) | |
| Enumeration Date | 2014-05-01 |
| Last Update Date | 2023-01-27 |