| NPI | 1821420795 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH Coa 14842) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY 351591) |
| Enumeration Date | 2013-08-02 |
| Last Update Date | 2023-05-08 |