| NPI | 1760765630 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: OH APRN.CNP025579) |
| Additional Taxonomies | 163WG0000X Registered Nurse General Practice (Licence: OH RN345615) |
| Enumeration Date | 2011-09-27 |
| Last Update Date | 2019-10-03 |