| NPI | 1659756260 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: OH COA.17631-NP) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH RN-290707-1) |
| Enumeration Date | 2015-07-24 |
| Last Update Date | 2021-01-14 |