| NPI | 1639411010 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: OH 14066-NP) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH NP-14066) |
| Enumeration Date | 2013-03-22 |
| Last Update Date | 2016-09-02 |