| NPI | 1679175384 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH LE-00034661) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH RN.370512) |
| 207Q00000X Family Medicine (Licence: OH LE-00034661) | |
| Enumeration Date | 2020-11-09 |
| Last Update Date | 2020-11-10 |