| NPI | 1619485984 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH APRN.CNP.026024)  | 
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 308393)  | 
| Enumeration Date | 2018-01-19 | 
| Last Update Date | 2020-03-10 |