| NPI | 1679561617 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: OH NP07068) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: OH RN267084) |
| Enumeration Date | 2005-10-13 |
| Last Update Date | 2012-07-30 |