| NPI | 1790782795 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: VA 0024174707) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0024174707) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: OH Rn154373 NP01084) | |
| Enumeration Date | 2005-07-05 |
| Last Update Date | 2019-03-06 |