| NPI | 1790111227 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP9946) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH 15139-NP) |
| Enumeration Date | 2013-09-16 |
| Last Update Date | 2018-09-24 |