| NPI | 1649782533 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: OH 161473) |
| Additional Taxonomies | 163WC1400X Registered Nurse, College Health (Licence: OH 161473) |
| Enumeration Date | 2017-10-31 |
| Last Update Date | 2017-10-31 |