| NPI | 1639584139 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MO 2015010647) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: OH COA15919NP) |
| Enumeration Date | 2014-06-24 |
| Last Update Date | 2015-06-29 |