| NPI | 1780957902 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH APRN.CNP.13370)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH RN.380624-COA1)  | 
| Enumeration Date | 2012-02-18 | 
| Last Update Date | 2021-07-26 |