NPI | 1639559867 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH 17421) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH COA.17421-NP) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2015-06-03 |
Last Update Date | 2022-08-02 |