| NPI | 1790857290 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: TN 33453) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH COA.09052-NP) |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2023-03-07 |