| NPI | 1790199115 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: OH X) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner Acute Care (Licence: OH COA-16307) |
| 363LP2300X Nurse Practitioner Primary Care (Licence: OH COA 16307) | |
| Enumeration Date | 2014-06-13 |
| Last Update Date | 2015-03-11 |