| NPI | 1649788803 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11007376) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH LE00022186) |
| Enumeration Date | 2018-01-22 |
| Last Update Date | 2021-11-03 |