| 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 |