| NPI | 1710505110 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: OH LE-00032052) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH LE-00032052) |
| Enumeration Date | 2020-07-12 |
| Last Update Date | 2022-05-09 |