NPI | 1669456125 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024168302) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH COA.06937-NP) |
Enumeration Date | 2005-11-30 |
Last Update Date | 2016-07-07 |