| NPI | 1780059493 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3011311) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH COA.18473-NP) |
| Enumeration Date | 2015-12-07 |
| Last Update Date | 2022-10-04 |