| NPI | 1659719367 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5006854) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5006854) |
| 363LF0000X Nurse Practitioner, Family (Licence: OH 14553) | |
| Enumeration Date | 2013-06-05 |
| Last Update Date | 2016-12-27 |