| NPI | 1679015259 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: FL 9447521) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: OH 019576) |
| 163W00000X Registered Nurse (Licence: OH 371708) | |
| Enumeration Date | 2016-11-14 |
| Last Update Date | 2020-07-31 |