| NPI | 1770673980 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: OH COA09109NP) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH APRN.CNP.09109) |
| 363LF0000X Nurse Practitioner, Family (Licence: OH NP09109) | |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2021-03-03 |