| NPI | 1720462989 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH COA.17597-NP) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: CT 10517) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 310734) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: PA SP025815) | |
| Enumeration Date | 2015-07-16 |
| Last Update Date | 2023-01-27 |