| NPI | 1720554132 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 25086) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH 026616) | 
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH RN.416114) | |
| Enumeration Date | 2018-10-23 | 
| Last Update Date | 2021-09-14 |