| NPI | 1629636717 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP022223) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA MB5990355) |
| 363LF0000X Nurse Practitioner, Family (Licence: OH 024709) | |
| Enumeration Date | 2019-06-03 |
| Last Update Date | 2020-09-22 |