| NPI | 1710655063 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH 0029553) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH 318726) |
| Enumeration Date | 2021-09-01 |
| Last Update Date | 2021-09-01 |