| NPI | 1710175179 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: OH 09704NP) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: OH COA.09704-NP) |
| Enumeration Date | 2007-10-11 |
| Last Update Date | 2021-01-22 |