| NPI | 1780978619 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH COA.12348-NP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA SP011356) |
| Enumeration Date | 2011-06-08 |
| Last Update Date | 2011-06-08 |