| NPI | 1720685803 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: OH APRN.CNP.0027771) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH RN.458579) |
| Enumeration Date | 2020-10-02 |
| Last Update Date | 2020-10-26 |