| NPI | 1790882025 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH COA.11091-NP) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0024166938) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2023-04-21 |