| NPI | 1679877427 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3006516) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH COA12017-NP) |
| Enumeration Date | 2011-01-07 |
| Last Update Date | 2020-05-21 |