| NPI | 1760728679 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3009999) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH APRN.CNP.022522) |
| Enumeration Date | 2012-12-20 |
| Last Update Date | 2021-07-07 |