| NPI | 1861751968 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: OH COA13726) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH COA13726) |
| Enumeration Date | 2012-05-09 |
| Last Update Date | 2015-05-07 |