| NPI | 1760028633 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: OH APRN.CNP.025791) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH APRN.CNP.025791) |
| Enumeration Date | 2019-11-25 |
| Last Update Date | 2021-11-10 |