| NPI | 1760750962 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH COA.12730-NP) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: OH COA.12730-NP) |
| Enumeration Date | 2011-12-02 |
| Last Update Date | 2016-11-28 |