| NPI | 1780054635 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: OH COA.18215-NP) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH APRN.CNP.18215) |
| Enumeration Date | 2015-10-05 |
| Last Update Date | 2021-03-01 |