| NPI | 1811302698 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: OH 2013004849)  | 
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: KY 1170359)  | 
| 363LF0000X Nurse Practitioner, Family (Licence: OH F0416175)  | |
| Enumeration Date | 2014-06-30 | 
| Last Update Date | 2021-01-13 |