| NPI | 1821411562 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 276144) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: NC 276144) |
| 363L00000X Nurse Practitioner (Licence: OH COA15469) | |
| Enumeration Date | 2014-01-31 |
| Last Update Date | 2017-10-23 |