| NPI | 1629535190 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3017813) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH APRN.CNP.025212) |
| Enumeration Date | 2019-02-21 |
| Last Update Date | 2023-05-16 |