| NPI | 1629200902 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH COA.10766-NP) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: OH RN241205) |
| Enumeration Date | 2009-08-20 |
| Last Update Date | 2011-05-23 |