| NPI | 1629406129 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024178930) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH APRN.CNP.019948) |
| Enumeration Date | 2013-10-18 |
| Last Update Date | 2021-01-12 |