| NPI | 1558790006 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH COA.17317-NP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0001248067) |
| Enumeration Date | 2013-11-05 |
| Last Update Date | 2020-02-04 |