| NPI | 1740400647 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35.092686) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 363LF0000X Nurse Practitioner Family (Licence: OH 35.092686) | |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2017-03-01 |