| NPI | 1629146063 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH COA.16931-NP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH RX.16931-EX1) |
| Enumeration Date | 2006-12-02 |
| Last Update Date | 2015-03-30 |