| NPI | 1710284310 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WA 61070761) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH RN304442-COA1) |
| 363LF0000X Nurse Practitioner Family (Licence: OH COA09814-NP) | |
| Enumeration Date | 2011-02-16 |
| Last Update Date | 2020-06-19 |