| NPI | 1760596951 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH 02334-NP)  | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH RN184865)  | 
| Enumeration Date | 2006-08-18 | 
| Last Update Date | 2012-01-20 |