| NPI | 1760481113 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: OH APRN.CNP.04623) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3001921) |
| Enumeration Date | 2005-07-19 |
| Last Update Date | 2016-12-05 |