| NPI | 1740631480 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: OH AG0616180) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: OH AG0616180) |
| Enumeration Date | 2016-06-23 |
| Last Update Date | 2016-06-24 |