| NPI | 1710978721 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH NP12932) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MT RN28818) |
| Enumeration Date | 2005-10-31 |
| Last Update Date | 2012-08-09 |