| NPI | 1639627839 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH APRNCNP020074) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3010512) |
| Enumeration Date | 2016-09-15 |
| Last Update Date | 2017-10-24 |