| NPI | 1598163750 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MT APRN100230)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH COA. 16855-NP)  | 
| 363LF0000X Nurse Practitioner, Family (Licence: MT NUR-RN-LIC-21384)  | |
| Enumeration Date | 2014-12-19 | 
| Last Update Date | 2023-09-13 |