| NPI | 1790141950 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3010829) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 71011968A) |
| 363LF0000X Nurse Practitioner, Family (Licence: OH 019970) | |
| 363LF0000X Nurse Practitioner, Family (Licence: KY 3010829) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH 402872) | |
| Enumeration Date | 2016-01-04 |
| Last Update Date | 2022-08-22 |