| NPI | 1700508769 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH APRN.CNP.0030033) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3018160) |
| Enumeration Date | 2022-09-16 |
| Last Update Date | 2022-12-30 |