| NPI | 1689924623 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH 16611) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TN 16776) |
| Enumeration Date | 2012-09-18 |
| Last Update Date | 2014-11-17 |