| NPI | 1578969101 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11005114) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH COA.16749-NP) |
| Enumeration Date | 2014-11-10 |
| Last Update Date | 2021-10-06 |