| NPI | 1568904779 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH APRN.CNP.020002) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH RN.334783) |
| 163W00000X Registered Nurse (Licence: GA RN294440) | |
| Enumeration Date | 2016-11-07 |
| Last Update Date | 2024-12-03 |