| NPI | 1790456986 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH LE-000383-20) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 29054) |
| Enumeration Date | 2021-09-27 |
| Last Update Date | 2025-03-20 |