| NPI | 1760843049 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MD R212891) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MD R212891) |
| 163W00000X Registered Nurse (Licence: OH RN.401394) | |
| Enumeration Date | 2016-03-14 |
| Last Update Date | 2016-03-14 |