| NPI | 1689721185 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH COA16761-NP) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 3374) |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2017-01-23 |