| NPI | 1700553641 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH APRN.CNP.0029774) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH LE-00038072) |
| Enumeration Date | 2021-08-27 |
| Last Update Date | 2022-07-13 |