| NPI | 1831466747 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 20205) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH COA 15085 NP) | 
| 363LF0000X Nurse Practitioner, Family (Licence: NC 207724) | |
| 363LF0000X Nurse Practitioner, Family (Licence: SC TL20205) | |
| Enumeration Date | 2011-11-20 | 
| Last Update Date | 2021-01-19 |