NPI | 1639587702 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9477789) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH RN302372) |
Enumeration Date | 2014-08-01 |
Last Update Date | 2025-08-20 |