| NPI | 1699761775 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3004637) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH 09960-NP) |
| Enumeration Date | 2005-09-23 |
| Last Update Date | 2015-05-06 |