| NPI | 1780794412 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11019862) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH RN262085) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2022-06-23 |