| NPI | 1760818561 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP5608) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH COA.14959-NP) |
| Enumeration Date | 2013-09-25 |
| Last Update Date | 2023-01-23 |