| NPI | 1588915250 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH COA.13902-NP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC APN.18323 TP) |
| 363LF0000X Nurse Practitioner, Family (Licence: SC APN.18323 RX) | |
| Enumeration Date | 2012-09-21 |
| Last Update Date | 2014-12-17 |