| NPI | 1699053868 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH COA.12773-NP) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: OH RN209986) |
| Enumeration Date | 2011-07-21 |
| Last Update Date | 2014-04-04 |