| NPI | 1760511414 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024171776) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH NP-07991) | 
| Enumeration Date | 2007-03-05 | 
| Last Update Date | 2025-08-15 |