| NPI | 1770864829 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SC 17990) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH 263283) |
| Enumeration Date | 2011-09-02 |
| Last Update Date | 2021-08-31 |