| NPI | 1568025765 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH APRN.CNP.024540) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH aprn.cnp.024540) |
| Enumeration Date | 2019-04-15 |
| Last Update Date | 2019-06-01 |