| NPI | 1760815641 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: WI 9118-33) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: OH COA.14704-NP) |
| Enumeration Date | 2013-08-15 |
| Last Update Date | 2020-02-04 |