| NPI | 1578962106 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: OH COA.16415-NP) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner Primary Care (Licence: OH COA.16415-NP) |
| Enumeration Date | 2014-08-20 |
| Last Update Date | 2015-03-30 |