| NPI | 1770030553 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH APRN.CNP.019668) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH 289335) |
| Enumeration Date | 2016-09-08 |
| Last Update Date | 2016-09-08 |