| NPI | 1750610523 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 2164847) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH COA.10939) |
| 363LF0000X Nurse Practitioner, Family (Licence: OH COA10939NP) | |
| Enumeration Date | 2009-12-08 |
| Last Update Date | 2014-02-11 |