| NPI | 1740736123 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH APRN.CNP.0028096) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 95005199) |
| Enumeration Date | 2016-08-26 |
| Last Update Date | 2022-01-19 |